- Associated Press - Wednesday, April 20, 2016

DES MOINES, Iowa (AP) - State senators said Wednesday that they have heard complaints about Iowa’s Medicaid program under private management and that state officials providing information on the new system should stop telling the public the transition has been smooth.

Members of the Senate Human Resources Committee said they have received emails and heard in person from Medicaid service providers and program recipients about problems, including questions over rejected claims and confusion about coverage. Members of the committee in the Democratic-majority Senate challenged a report at the start of the meeting from a state official that there are no systemic issues.

“You’re not hearing what we’re hearing,” said Sen. Bill Dotzler, D-Waterloo. “It’s not all roses.”

Lawmakers said the problems clearly conflict with reports from Republican Gov. Terry Branstad’s office and others that there have been no serious problems since three insurance companies took over Medicaid on April 1.

“I would hope that we could just end the rosy press releases,” Sen. Joe Bolkcom, D-Iowa City. “It’s really insulting to people.”

Ben Hammes, a Branstad spokesman, defended reports from the governor’s office over the program.

“These stories are just a small sample of the positive interactions that some Medicaid patients are experiencing,” Hammes said in an email.

State officials and representatives for the insurance companies countered some alleged issues, but they also said they’ll investigate ongoing complaints. They also said they wanted to work with service providers over any billing issues.

“Our interest is to ensure that providers understand every detail and we will work with them, whether that is in person, whether it is via a webinar. Whatever meets their schedule to ensure that they understand how to interact with us,” said Kim Foltz, a representative for UnitedHealthcare, one of the three insurance companies.

The legislative committee plans to meet over the next several months to continue investigating complaints.

The $4.2 billion Medicaid program provides health care to about 560,000 poor and disabled Iowa residents. The program switched to private management amid calls from Branstad to contain growing costs within the program, which is funded with state and federal dollars. Critics have challenged possible savings under the new system. Branstad says privatization of Medicaid will offer better care to patients.

Democrats were vocal for months about their criticism of the privatization plan and the ensuing transition. They argued the state wasn’t ready and federal officials overseeing the switch delayed implementation by several months over readiness issues.

State officials with the Iowa Department of Health and Human Services, which used to run Medicaid, defend the new system. They’ve appeared alongside representatives for the insurance companies to answer questions from lawmakers.

The Iowa Legislature is in the midst of passing a budget bill that would include more state oversight of privatized Medicaid, but those details are still being sorted out.


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